Given that October 6, 2016 is National Depression Screening Day, and millions of people suffer from some form of depression each year in the United States, I thought it appropriate to write about depression in a blog post. I have been a clinician for over a decade now; have seen my fair share of clients who struggle with depression (either chronic depression on its own or in conjunction with anxiety or another emotional challenge); and have been trained in at least three treatment modalities (cognitive-behavioral therapy, interpersonal therapy, and most recently neurobiology of attachment theory). While I think the most effective type of treatment approach varies, depending to some extent on the individual and what best suits his or her situation, each approach has something to offer. Yet, no approach focuses on two essential factors that I think can make a significant difference in shaping the person’s perceptions of their life and the reality in which they live.

The first key factor that I believe gets downplayed by popular theories and practices in treating depression is the concept of self. Now, our culture is obsessed with the idea of self and all of its family members: self-love; self-confidence; self-esteem; self-worth, and, of course, no list of ideas about the self is complete without the selfie.

Wikipedia defines “self” as “the subject of one’s own experience of phenomenon: perceptions, emotions, thoughts, etc. So, if we spend a great deal of time focusing on ourselves, it is possible that we will form many perceptions based on our own experiences. This can have a healthy outcome, as long as our experiences are accurate and positive. However, society encourages us to love ourselves, focus on ourselves first, believe in ourselves, and be ourselves. Those are all good ideas, right? Not necessarily…

I agree with popular culture and psychology that we must take care of ourselves; physically, emotionally, and spiritually. But for many people who grow up in homes where this concept is neither addressed nor embraced, many children become adults without understanding themselves, knowing what their needs are, and knowing how to engage in self-care. Furthermore, it isn’t just about us. People who believe that self-love is most important, to the degree that they focus more on themselves than others most of the time, often find themselves lonely, or in dysfunctional, high-conflict relationships.

The point I am striving to make is that without a good education on a healthy concept of self, people fill in the blanks and often make poor choices by either choosing to exclusively prioritize themselves first or by ignoring their own needs to fulfill the needs of others. Unhealthy self-focus and self-neglect are equally toxic to an individual’s mental health and to their relationships. Unhealthy self-focus can lead to depression even if the person has very negative self-perceptions rather than overly positive or inflated beliefs about the self. Thinking mostly about ourselves allows us to constantly criticize ourselves, compare ourselves to others, identify new flaws, and pick apart many of our physical and mental characteristics. Therefore, we cannot continuously look inward; we must look outward beyond ourselves and in the direction of others.

This leads to the second factor that I believe is critical for a healthy self-concept and to freedom from the cycle of depression that can be so paralyzing. Empathy, defined as “the ability to understand and share the feelings of others,” provides us with a freedom from the paralysis of self-indulgence. It may seem counter-intuitive to say that focusing on the hardships of others would help someone struggling emotionally. But it makes sense, as long as we are not talking about going from the extreme of self-focus to the other extreme of focusing only on the needs of others. Learning to understand the feelings and struggles of others allows us to see that we are not alone. Mirroring the self in others and observing differences between the self and others are both important – one allows us to understand that we are all mere mortals on the path of humanity; the other allows us to understand that we all have uniqueness in both flaws and attributes. Feeling that one is not alone and knowing that every human being has unique characteristics can make a huge difference in how someone thinks and feels about themselves. But if they are focused much more inwardly, they will miss many opportunities to know and understand how others play an important role in shaping who we are as individuals.

Empathy takes a step beyond merely noticing others to actually attempting to understand the perspective of others. This frees us from believing that we have all the answers, that we have to do life alone, and that we are the only one in need of support and compassion. For individuals struggling with chronic depression, shame can result in the belief that we are a drain to others and that we don’t deserve support. Engaging in active empathy toward others allows everyone to contribute in providing understanding and kindness to others.

In sum, we are all in this together, so let’s turn from exclusive self-focus to know and understand those around us. Then our struggles will make more sense. We can join together to lend support and find solutions. For individuals struggling with depression, knowing they are not alone, understanding that others suffer, and that many people struggle even more than they do, and feeling like they can be helpful to others can all be powerful messages that break the cycle of helpless and hopelessness of which they have become accustomed.

Here are five points to consider when feeling depressed, or when supporting a depressed person:

If you observe many daily thoughts about yourself that are negative, critical, or inwardly focused on your failures and shortcomings, write down a few of these thoughts. Challenge yourself to find a rational alternative, or ask someone you love or trust to help you in this task.

When you find yourself thinking often of yourself, take a break from thinking. Pause to have a conversation with someone. Ask them how they are doing or follow up on something happening in their lives.

Do you sometimes struggle to have empathy for others? Perhaps choose a person that you know, and think about them and their circumstances. Is there anything about your perspective that you could modify to feel more empathic towards them?

Do something nice for someone in need. It can be as small of a gesture as paying them a compliment or sending them an email to let them know that you are thinking of them. If you have more time or energy, you could offer something bigger, such as spending time with them, running an errand for them, or making a meal for them. Don’t know anyone in need? Volunteer at a community organization.

Tell those who are close to you that you love and appreciate them. It could be a family member, close friend, significant other, or someone in your life who supported you either in the past or presently. Research has shown that demonstrating kindness and gratitude improves the mood of most people.

None of these strategies will cure depression. It is a complicated condition that can be chronic and severe. It can result in debilitating loss of functioning across areas of one’s life. But as is the case with most circumstances, one must take a series of steps forward in order to achieve freedom from the grip of depression. Many people may be surprised at how shifting the focus from an internal perspective to a more balanced view that includes others, and intentional acts of empathy and compassion can begin to change one’s perspective in positive and hopeful ways.

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The content found on this website is intended to provide basic information and to raise awareness of important mental health topics. It is not intended to be a form of or a substitute for mental health counseling or psychotherapy.